HospItal Based Cancer Registry

Transcription

1 HospItal Based Cancer Registry Regional Cancer Centre, Thiruvananthapuram Dr Paul Sebastian, Principal Investigator Dr Aleyamma Mathew, Additional Professor in Statistics & Epidemiology (In-charge) The Hospital Based Cancer Registry (HBCR) of the Regional Cancer Centre (RCC), Thiruvananthapuram started in 1982 under the network of Indian Council of Medical Research (ICMR). The RCC is an exclusive cancer specialty hospital established in 1981 and today caters to more than 14,000 new patients in Kerala, which is one third of the new cancer patient load in one calendar year in the State of Kerala (population in Kerala: approximately 31 million as on 2001 census of India). The RCC also caters to patients from the neighbouring state of Tamil Nadu and the neighbouring countries such as the Maldives (approximately 1,500 new cancer patients). The data abstraction and entry for invasive cancers are done using an in-house developed web based software rccintranet.org. The demographic details are collected and entered into the computer at the time of new patient registration at RCC and transferred to the core-proforma of the National Cancer Registry Programme (NCRP) of ICMR. The data transfer avoids manual documentation of the first part (demographic details) of the ICMR core-proforma. The second part (diagnostic, treatment and follow-up details) is entered using the above software after retrieving case-sheets from the RCC medical records. All variables in the core-proforma except age and various dates are directly selected from a selection box in the hyper textmark up language (HTML) form. The selection box contains all the codes along with their descriptions for each variable. The selection box corresponding to the variables topography and morphology contains the third edition of international classification of diseases for oncology (ICD-O-3) and the latest edition of an International Classification of Diseases (). The database was subjected to a series of consistency checks (comparing the values of certain variables against others) to ensure that valid codes were entered using in-house software. The data was edited based on the error list of cases obtained using the above check program. After editing, the data was sent to the Coordinating Unit of the NCRP (ICMR), Bangalore in an electronic format and subjected again to various range, consistency, unlikely combinations, and duplicate checks. Necessary corrections were done based on the error list of cases sent by the coordinating unit. Since its inception in 1982 (n=3696), the RCC has been recording increasing number of patients and in 2010 there were 13,049 patients (6379 males and 6670 females) which is 253% more than in Among 13,049 patients in 2010, 89.1% (n=11,627; 5794 males and 5833 females) of cases were invasive, 0.5% (n=61) were in-situ and 1.6% (n=205) were borderline malignancies. Date 236

2 of diagnosis was 2010 itself for 10,251 (88.2%) cases and the remaining cases had their date of diagnosis in the previous years. Average age at diagnosis of cancer cases was 53.5 years (SD: 18.0 years) in males and 49.7 years (SD: 16.7 years) in females. Among males, lung cancer (14.5%) was the leading site followed by cancer of the oral cavity (14.2%) and among females, cancer of the breast (29.8%) was the leading site followed by cancer of the thyroid (12.5%). Children (0-14 years) constituted 4.8% of all cancers. In children, leukemia (57.5% in males & 47.5% in females) was the predominant cancer in both genders. 10% of all cancers were in the age group years. In this age group, the leading cancers were leukemia in males (24.2%) and thyroid cancer in females (37.8%). 61.4% of all cancers were in the age group years. In this age group, the leading cancer sites were oral cavity in males (15.9%) and breast in females (36.3%). 24.0% of all cancers were in the age group 65+ years. In this age group, the leading cancer sites were lung in males (18.2%) and breast in females (22.4%). The proportion of tobacco related cancers (oral cavity, pharynx, oesophagus, larynx, lung and urinary bladder) relative to all cancers was 39.6% in males and 10.7% in females. Among the cancer cases (n=11,627), diagnosis by microscopic verification was available in 93.2% of males and 96.5% of females. Among the microscopically diagnosed cancer cases (n=11,032), histology from primary site was available for 70% in males and 77% in females. Among the cancer cases, 7799 (67%) cases reported at RCC for the first time without any cancer directed treatment and the remaining cases (n=3828) had undergone partial treatment elsewhere before registration at RCC. Among the previously untreated cases, 67.4% of males, 67% of females had disease extending or spreading beyond the primary site of cancer. Among the previously untreated patients (n=7799), intention to treat was radical for 65.4% of patients. Among the previously untreated patients (n=7799), 80% received complete cancer directed treatment and among the patients who received first treatment elsewhere (n=3828), 60% received rest of the cancer directed treatment at RCC. Chemotherapy alone or combination with other modalities was the predominant form of treatment among the previously untreated patients (46.8%), as well as among the patients who received first treatment elsewhere (33.9%). Radiotherapy alone or in combination with the other form of treatment was 38.7% among the previously untreated patients and 31.5% among the patients who received first treatment elsewhere. Other Ongoing Programmes Utilising HBCR Data 1. District Cancer Registry, Thiruvananthapuram 2. District Cancer Registry, Kollam 3. Patterns of Care and Survival of Head & Neck, Breast and Cervix Cancer 237

3 4. Cancer Control Programme, Thiruvananthapuram Corporation 5. Thiruvananthapuram Jilla Panchayat Cancer Control Programme 6. Case-control study of bladder & kidney cancers 7. Nutritional factors and risk of breast cancer: a case-control study Indexed Publications Utilising Registry Data and Involved by the Registry Staff during the past 3 years 1. Jayakrishnan R, Mathew A, Lekshmi K, Sebastian P, Finne P, Uutela A. Assessment of nicotine dependence among smokers in a selected rural population in Kerala, India. Asian Pac J Cancer Prev. 2012; 13(6): Balagopal PG, George NA, Venugopal A, Mathew A, Ahamed MI, Sebastian P. Tobacco related habits among first degree relatives of patients undergoing surgery for advanced head and neck malignancies in India. Asian Pac J Cancer Prev. 2012; 13(1): Jayakrishnan R, Mathew A, Uutela A, Finne P. A community based smoking cessation intervention trial for rural Kerala, India. Asian Pac J Cancer Prev. 2011; 12(12): Nooyi SC, Murthy NS, Shivananjaiah S, Sreekantaiah P, Mathew A. Trends in rectal cancer incidence - Indian scenario. Asian Pac J Cancer Prev. 2011; 12(8): Ganesh B, Swaminathan R, Mathew A, Sankaranarayanan R, Hakama M. Loss-adjusted hospital and population-based survival of cancer patients. IARC SciPubl,2011; (162): Mathew A, Daniel CR, Ferrucci LM, Seth T, Devesa SS, George PS, Shetty H, Devasenapathy N, Yurgalevitch S, Tanuja Rastogi, Prabhakaran D, Gupta PC, Chatterjee N, Rashmi Sinha. Assessment of follow-up, and the completeness and accuracy of cancer case ascertainment in three areas of India. Cancer Epidemiol Aug; 35(4): Sinha R, Daniel CR, Devasenapathy N, Shetty H, Yurgalevitch S, Ferrucci LM, George PS, Morrissey KG, Ramakrishnan L, Graubard BI, Kapur K, Reddy KS, McAdams MJ, Rastogi T, Chatterjee N, Gupta PC, Wacholder S, Prabhakaran D, Mathew A. Multi-center feasibility study evaluating recruitment, variability in risk factors and biomarkers for a diet and cancer cohort in India. BMC Public Health May 27; 11: Nair M, Prabhakaran D, Narayan KM, Sinha R, Lakshmy R, Devasenapathy N, Daniel CR, Gupta R, George PS, Mathew A, Tandon N, Reddy KS. HbA(1c) values for defining diabetes and impaired fasting glucose in Asian Indians. Prim Care Diabetes Jul; 5(2): Moore SC, Gunter MJ, Daniel CR, Reddy KS, George PS, Yurgalevitch S, Devasenapathy N, Ramakrishnan L, Chatterjee N, Chanock SJ, Berndt SI, Mathew A, Prabhakaran D, Sinha R. Common Genetic Variants and Central Adiposity Among Asian-Indians. Obesity (Silver Spring) Jul Daniel CR, Prabhakaran D, Kapur K, Graubard BI, Devasenapathy N, Ramakrishnan L, George PS, Shetty H, Ferrucci LM, Yurgalevitch S, Chatterjee N, Reddy KS, Rastogi T, Gupta PC, Mathew A, Sinha R. A cross-sectional investigation of regional patterns of diet and cardio-metabolic risk in India. Nutr J Jan 28;10:

4 11. Ferrucci LM, Daniel CR, Kapur K, Chadha P, Shetty H, Graubard BI, George PS, Osborne W, Yurgalevitch S, Devasenapathy N, Chatterjee N, Prabhakaran D, Gupta PC, Mathew A, Sinha R. Measurement of spices and seasonings in India: opportunities for cancer epidemiology and prevention. Asian Pac J Cancer Prev. 2010; 11(6): Murthy NS, Shalini S, Sastry NB, Suman G, Sreekantaiah P, Mathew A. Increase in incidence of cancer of corpus uteri: estimation of time trends - an Indian scenario. Eur J Cancer Prev Jan; 20(1): Murthy NS, Rajaram D, Gautham MS, Shivraj NS, Pruthvish S, George PS, Mathew A. Trends in Incidence of Gall bladder Cancer Indian Scenario. Gastrointestinal Cancer: Targets and Therapy (2011): Murthy NS, Nandakumar BS, Shivaraj NS, Pruthvish S, Shalini CN, Chaudhry K, Mathew A. Cancer registration: its relevance for health care planning in India. Indian J Prev Soc Med 2010/41 (1): Murthy NS, Nandakumar BS, Pruthvish S, George PS, Mathew A. Disability adjusted life years for cancer patients in India. Asian Pac J Cancer Prev. 2010/11 (3): Paul M, George PS, Mathew A. Patient and disease related factors associated with lost-to follow-up/ drop-outs of cervical cancer patients. A study at a major cancer hospital in South India. Asian Pac J Cancer Prev 2010/11 (4): Varghese BT, Mathew A, Sebastian P, Iype EM, Vijay A. Source Comparison of quality of life between voice rehabilitated and nonrehabilitatedlaryngectomies in a developing world community. Acta Otolaryngol. 2011/ Mar; 131(3): Moore M, Ariyaratne Y, Badar F, Yasmin Bhurgri, Datta K, Mathew A, Gangadharan P, Nandakumar A, Pradhananga KK, Talukder MH, Yeole BB, Sobue T. Cancer epidemiology in South Asia - past, present and future. Asian Pac J Cancer Prev 11 Suppl 2010/2: Shakeel MK, George PS, Josna Jose, Jesna Jose and Mathew A. Pesticides and breast cancer risk: a comparison between developed and developing countries. Asian Pacific J Cancer Prev 2010/11: Thomas M, George NA, Gowri BP, George PS, Sebastian P. Comparative evaluation of ASA classification and ACE-27 index as morbidity scoring systems in oncosurgeries. Indian J Anaesthesia 2010/54: Thomas M, George NA, Balagopal PG, George PS, Sebastian P. A novel morbidity prediction score for head and neck oncosurgeries. Indian Journal of Surgery 2010/72(6): Murthy NS, Shalini S, Suman G, Pruthvish S, Mathew A. Changing trends in incidence of ovarian cancer - the Indian scenario. Asian Pacific J Cancer Prev, 2009/10: George PS and Mathew A. Risk estimation per unit change from summarized data and empirical comparisons. Stars International journal. 2009/3(1):

5 24. Mathew A, Gajalakshmi V, Rajan B, Kanimozhi V, Brennan P, Binukumar B, Boffetta P. Physical activity level among urban and rural women in south India and the risk of breast cancer: a case-control study. European Journal of Cancer Prevention. 2009/18: Mathew A and George PS. Trends in incidence and mortality rates of squamous cell and adenocarcinoma of cervix worldwide. Asia Pacific Journal of Cancer Prevention. 2009/10: Mathew A, George PS, Ildaphonse G. Obesity and kidney cancer risk in women a systematic review and meta-analysis ( ). Asia Pacific Journal of Cancer Prevention. 2009/10: Varghese BT, Sebastian P, Mathew A. Treatment outcome in patients undergoing surgery for carcinoma larynx and hypopharynx A follow-up study. Acta Oto-Laryngologica. 2009/129: Dey S, Boffetta P, Mathews A, Brennan P, Soliman A, Mathew A. Risk factors according to estrogen receptor status of breast cancer patients in Trivandrum, South India. Int J Cancer. 2009/125; Gajalakshmi V, Mathew A, Brennan B, Rajan B, Kanimozhi V, Rai RR, Mathews A, Mathew BS, Boffetta P. Breastfeeding and breast cancer risk in India: a multicenter case-control study. Int J Cancer 2009/125; Rema PN, Suchetha S, Mathew AP, Mathew A, Sebastian P. Secondary cytoreduction in epithelial ovarian cancer recurrence: a perspective from a regional cancer center in India. J Reprod Med. 2009/54(8): List of Other Staff Working for the Registry Mrs Padmakumari Amma G. : Assistant Professor in Bio-Statistics Dr Kalavathy M.C. : Assistant Professor in Epidemiology Dr Preethi Sara George : Assistant Professor in Bio-Statistics Mrs Anita Nayar : Social Investigator, Sr. Grade Mrs Asha N.M. : Clerk Mr Prasanthkumar R.K. : Data Entry Operator 240

6 Table: TVM-1(a): Number of Cancers by Site () and Five Year Age Group: Males Unk= Unknown; %= Relative Proportion of Cancers of All Sites Unk Total % C00 Lip C01-02 Tongue C03-06 Mouth C07-08 Salivary Gland C09 Tonsil C10 Oth. Oropharynx C11 Nasopharynx C12-13 Hypopharynx C14 Pharynx Unspecified C15 Oesophagus C16 Stomach C17 Small Intestine C18 Colon C19-20 Rectum C21 Anus & Anal Canal C22 Liver C23-24 Gallbladder etc C25 Pancreas C30-31 Nose, Sinuses etc C32 Larynx C33-34 Lung etc C37-38 Other Thoracic Organs C40-41 Bone C43 Melanoma of Skin C44 Other Skin C45 Mesothelioma C46 Kaposi Sarcoma C47+C49 Conn. & Soft Tissue C50 Breast C60 Penis C61 Prostate C62 Testis C63 Other Male Genital C64 Kidney etc C65 Renal Pelvis C66 Ureter C67 Bladder C68 Uns.Urinary Organs C69 Eye C70-72 Brain, Nervous System C73 Thyroid C74 Adrenal Gland C81 Hodgkins Disease C82-85,C96 NHL C88 Malig Imn.Prol D C90 Multiple Myeloma C91 Lymphoid Leuk C92-94 Myeloid Leukaemia C95 Leukaemia Uns O&U Other and Uns All Sites * O&U includes the Sites (: C26, C39, C48, C75, C76, C77, C78, C79, C80, C97) 241

7 Table: TVM-1(b): Number of Cancers by Site () and Five Year Age Group: Females Unk= Unknown; %= Relative Proportion of Cancers of All Sites Unk Total % C00 Lip C01-02 Tongue C03-06 Mouth C07-08 Salivary Gland C09 Tonsil C10 Oth. Oropharynx C11 Nasopharynx C12-13 Hypopharynx C14 Pharynx Unspecified C15 Oesophagus C16 Stomach C17 Small Intestine C18 Colon C19-20 Rectum C21 Anus & Anal Canal C22 Liver C23-24 Gallbladder etc C25 Pancreas C30-31 Nose, Sinuses etc C32 Larynx C33-34 Lung etc C37-38 Other Thoracic Organs C40-41 Bone C43 Melanoma of Skin C44 Other Skin C45 Mesothelioma C46 Kaposi Sarcoma C47+C49 Conn. & Soft Tissue C50 Breast C51 Vulva C52 Vagina C53 Cervix Uteri C54 Corpus Uteri C55 Uterus Unspecified C56 Ovary etc C57 Other Female Genital C58 Placenta C64 Kidney etc C65 Renal Pelvis C66 Ureter C67 Bladder C68 Uns.Urinary Organs C69 Eye C70-72 Brain, NS C73 Thyroid C74 Adrenal Gland C81 Hodgkins Disease C82-85,C96 NHL C88 Malig Imn.Prol D C90 Multiple Myeloma C91 Lymphoid Leuk C92-94 Myeloid Leukaemia C95 Leukaemia Uns O&U Other and Uns All Sites * O&U includes the Sites (: C26, C39, C48, C75, C76, C77, C78, C79, C80, C97) 242

8 Table: TVM-2(a): Number (#) and Proportion (%) of Cancers by Site () and Method of Diagnosis: Males Microscopic X -Ray/Imaging Clinical Others Unknown Total # % # % # % # % # % # % C00 Lip C01-02 Tongue C03-06 Mouth C07-08 Salivary Gland C09 Tonsil C10 Oth. Oropharynx C11 Nasopharynx C12-13 Hypopharynx C14 Pharynx Unspecified C15 Oesophagus C16 Stomach C17 Small Intestine C18 Colon C19-20 Rectum C21 Anus & Anal Canal C22 Liver C23-24 Gallbladder etc C25 Pancreas C30-31 Nose, Sinuses etc C32 Larynx C33-34 Lung etc C37-38 Other Thoracic Organs C40-41 Bone C43 Melanoma of Skin C44 Other Skin C45 Mesothelioma C46 Kaposi Sarcoma C47+C49 Conn. & Soft Tissue C50 Breast C60 Penis C61 Prostate C62 Testis C63 Other Male Genital C64 Kidney etc C65 Renal Pelvis C66 Ureter C67 Bladder C68 Uns.Urinary Organs C69 Eye C70-72 Brain, Nervous System C73 Thyroid C74 Adrenal Gland C81 Hodgkins Disease C82-85,C96 NHL C88 Malig Imn.Prol D C90 Multiple Myeloma C91 Lymphoid Leuk C92-94 Myeloid Leukaemia C95 Leukaemia Uns O&U Other and Uns All Sites * O&U includes the Sites ( : C26, C39, C48, C75, C76, C77, C78, C79, C80, C97) 243

9 Table: TVM-2(b): Number (#) and Proportion (%) of Cancers by Site () and Method of Diagnosis: Females Microscopic X -Ray/Imaging Clinical Others Unknown Total # % # % # % # % # % # % C00 Lip C01-02 Tongue C03-06 Mouth C07-08 Salivary Gland C09 Tonsil C10 Oth. Oropharynx C11 Nasopharynx C12-13 Hypopharynx C14 Pharynx Unspecified C15 Oesophagus C16 Stomach C17 Small Intestine C18 Colon C19-20 Rectum C21 Anus & Anal Canal C22 Liver C23-24 Gallbladder etc C25 Pancreas C30-31 Nose, Sinuses etc C32 Larynx C33-34 Lung etc C37-38 Other Thoracic Organs C40-41 Bone C43 Melanoma of Skin C44 Other Skin C45 Mesothelioma C46 Kaposi Sarcoma C47+C49 Conn. & Soft Tissue C50 Breast C51 Vulva C52 Vagina C53 Cervix Uteri C54 Corpus Uteri C55 Uterus Unspecified C56 Ovary etc C57 Other Female Genital C58 Placenta C64 Kidney etc C65 Renal Pelvis C66 Ureter C67 Bladder C68 Uns.Urinary Organs C69 Eye C70-72 Brain, Nervous System C73 Thyroid C74 Adrenal Gland C81 Hodgkins Disease C82-85,C96 NHL C88 Malig Imn.Prol D C90 Multiple Myeloma C91 Lymphoid Leuk C92-94 Myeloid Leukaemia C95 Leukaemia Uns O&U Other and Uns All Sites * O&U includes the Sites ( : C26, C39, C48, C75, C76, C77, C78, C79, C80, C97) 244

10 Table: TVM-3(a): Number (#) and Proportion (%) of Cancers by Site () and Detailed Microscopic Diagnosis: Males Pri. Hist. Sec. Hist. Cytology Blood Film Bone Marrow Others Total # % # % # % # % # % # % # % C00 Lip C01-02 Tongue C03-06 Mouth C07-08 Salivary Gland C09 Tonsil C10 Oth. Oropharynx C11 Nasopharynx C12-13 Hypopharynx C14 Pharynx Unspecified C15 Oesophagus C16 Stomach C17 Small Intestine C18 Colon C19-20 Rectum C21 Anus & Anal Canal C22 Liver C23-24 Gallbladder etc C25 Pancreas C30-31 Nose, Sinuses etc C32 Larynx C33-34 Lung etc C37-38 Other Thoracic Organs C40-41 Bone C43 Melanoma of Skin C44 Other Skin C45 Mesothelioma C46 Kaposi Sarcoma C47+C49 Conn. & Soft Tissue C50 Breast C60 Penis C61 Prostate C62 Testis C63 Other Male Genital C64 Kidney etc C65 Renal Pelvis C66 Ureter C67 Bladder C68 Uns.Urinary Organs C69 Eye C70-72 Brain, Nervous System C73 Thyroid C74 Adrenal Gland C81 Hodgkins Disease C82-85,C96 NHL C88 Malig Imn.Prol D C90 Multiple Myeloma C91 Lymphoid Leuk C92-94 Myeloid Leukaemia C95 Leukaemia Uns O&U Other and Uns All Sites * O&U includes the Sites ( : C26, C39, C48, C75, C76, C77, C78, C79, C80, C97) Pri. Hist=Primary Histology; Sec. Hist.=Secondary Histology 245

11 Table: TVM-3(b): Number (#) and Proportion (%) of Cancers by Site () and Detailed Microscopic Diagnosis: Females Pri. Hist. Sec. Hist. Cytology Blood Film Bone Marrow Others Total # % # % # % # % # % # % # % C00 Lip C01-02 Tongue C03-06 Mouth C07-08 Salivary Gland C09 Tonsil C10 Oth. Oropharynx C11 Nasopharynx C12-13 Hypopharynx C14 Pharynx Unspecified C15 Oesophagus C16 Stomach C17 Small Intestine C18 Colon C19-20 Rectum C21 Anus & Anal Canal C22 Liver C23-24 Gallbladder etc C25 Pancreas C30-31 Nose, Sinuses etc C32 Larynx C33-34 Lung etc C37-38 Other Thoracic Organs C40-41 Bone C43 Melanoma of Skin C44 Other Skin C45 Mesothelioma C46 Kaposi Sarcoma C47+C49 Conn. & Soft Tissue C50 Breast C51 Vulva C52 Vagina C53 Cervix Uteri C54 Corpus Uteri C55 Uterus Unspecified C56 Ovary etc C57 Other Female Genital C58 Placenta C64 Kidney etc C65 Renal Pelvis C66 Ureter C67 Bladder C68 Uns.Urinary Organs C69 Eye C70-72 Brain, Nervous System C73 Thyroid C74 Adrenal Gland C81 Hodgkins Disease C82-85,C96 NHL C88 Malig Imn.Prol D C90 Multiple Myeloma C91 Lymphoid Leuk C92-94 Myeloid Leukaemia C95 Leukaemia Uns O&U Other and Uns All Sites * O&U includes the Sites ( : C26, C39, C48, C75, C76, C77, C78, C79, C80, C97) Pri. Hist=Primary Histology; Sec. Hist.=Secondary Histology 246

12 Table: TVM-4(a): Number (#) and Proportion (%) of Cancers by Site () and Broad Treatment Group: Males Treatment Groups Prior Tmt. Only Prior & Tmt. at RI Tmt. Only at RI No Treatment Total # % # % # % # % # % C00 Lip C01-02 Tongue C03-06 Mouth C07-08 Salivary Gland C09 Tonsil C10 Oth. Oropharynx C11 Nasopharynx C12-13 Hypopharynx C14 Pharynx Unspecified C15 Oesophagus C16 Stomach C17 Small Intestine C18 Colon C19-20 Rectum C21 Anus & Anal Canal C22 Liver C23-24 Gallbladder etc C25 Pancreas C30-31 Nose, Sinuses etc C32 Larynx C33-34 Lung etc C37-38 Other Thoracic Organs C40-41 Bone C43 Melanoma of Skin C44 Other Skin C45 Mesothelioma C46 Kaposi Sarcoma C47+C49 Conn. & Soft Tissue C50 Breast C60 Penis C61 Prostate C62 Testis C63 Other Male Genital C64 Kidney etc C65 Renal Pelvis C66 Ureter C67 Bladder C68 Uns. Urinary Organs C69 Eye C70-72 Brain, Nervous System C73 Thyroid C74 Adrenal Gland C81 Hodgkins Disease C82-85,C96 NHL C88 Malig Imn. Prol D C90 Multiple Myeloma C91 Lymphoid Leuk C92-94 Myeloid Leukaemia C95 Leukaemia Uns O&U Other and Uns All Sites * O&U includes the Sites ( : C26, C39, C48, C75, C76, C77, C78, C79, C80, C97) Tmt.= Treatment 247

13 Table: TVM-4(b): Number (#) and Proportion (%) of cancers by site () and Broad Treatment Group: Females Treatment Groups Prior Tmt. Only Prior & Tmt. at RI Tmt. Only at RI No Treatment Total # % # % # % # % # % C00 Lip C01-02 Tongue C03-06 Mouth C07-08 Salivary Gland C09 Tonsil C10 Oth. Oropharynx C11 Nasopharynx C12-13 Hypopharynx C14 Pharynx Unspecified C15 Oesophagus C16 Stomach C17 Small Intestine C18 Colon C19-20 Rectum C21 Anus & Anal Canal C22 Liver C23-24 Gallbladder etc C25 Pancreas C30-31 Nose, Sinuses etc C32 Larynx C33-34 Lung etc C37-38 Other Thoracic Organs C40-41 Bone C43 Melanoma of Skin C44 Other Skin C45 Mesothelioma C46 Kaposi Sarcoma C47+C49 Conn. & Soft Tissue C50 Breast C51 Vulva C52 Vagina C53 Cervix Uteri C54 Corpus Uteri C55 Uterus Unspecified C56 Ovary etc C57 Other Female Genital C58 Placenta C64 Kidney etc C65 Renal Pelvis C66 Ureter C67 Bladder C68 Uns. Urinary Organs C69 Eye C70-72 Brain, Nervous System C73 Thyroid C74 Adrenal Gland C81 Hodgkins Disease C82-85,C96 NHL C88 Malig Imn. Prol D C90 Multiple Myeloma C91 Lymphoid Leuk C92-94 Myeloid Leukaemia C95 Leukaemia Uns O&U Other and Uns All Sites * O&U includes the Sites ( : C26, C39, C48, C75, C76, C77, C78, C79, C80, C97) Tmt.= Treatment 248

14 Table: TVM-5(a): Number (#) and Proportion (%) of cancers by site () and Clinical Extent of Disease: Males * O&U includes the Sites ( : C26, C39, C48, C75, C76, C77, C78, C79, C80, C97) Treatment Only at RI, No Treatment Clinical Extent of Disease Localised Regional Distant Others Unknown Total # % # % # % # % # % # % C00 Lip C01-02 Tongue C03-06 Mouth C07-08 Salivary Gland C09 Tonsil C10 Oth. Oropharynx C11 Nasopharynx C12-13 Hypopharynx C14 Pharynx Unspecified C15 Oesophagus C16 Stomach C17 Small Intestine C18 Colon C19-20 Rectum C21 Anus & Anal Canal C22 Liver C23-24 Gallbladder etc C25 Pancreas C30-31 Nose, Sinuses etc C32 Larynx C33-34 Lung etc C37-38 Other Thoracic Organs C40-41 Bone C43 Melanoma of Skin C44 Other Skin C45 Mesothelioma C46 Kaposi Sarcoma C47+C49 Conn. & Soft Tissue C50 Breast C60 Penis C61 Prostate C62 Testis C63 Other Male Genital C64 Kidney etc C65 Renal Pelvis C66 Ureter C67 Bladder C68 Uns.Urinary Organs C69 Eye C70-72 Brain, Nervous System C73 Thyroid C74 Adrenal Gland C81 Hodgkins Disease C82-85,C96 NHL C88 Malig Imn.Prol D C90 Multiple Myeloma C91 Lymphoid Leuk C92-94 Myeloid Leukaemia C95 Leukaemia Uns O&U Other and Uns All Sites

15 Table: TVM-5(b): Number (#) and Proportion (%) of cancers by site () and Clinical Extent of Disease: Females Treatment Only at RI, No Treatment Clinical Extent of Disease Localised Regional Distant Others Unknown Total # % # % # % # % # % # % C00 Lip C01-02 Tongue C03-06 Mouth C07-08 Salivary Gland C09 Tonsil C10 Oth. Oropharynx C11 Nasopharynx C12-13 Hypopharynx C14 Pharynx Unspecified C15 Oesophagus C16 Stomach C17 Small Intestine C18 Colon C19-20 Rectum C21 Anus & Anal Canal C22 Liver C23-24 Gallbladder etc C25 Pancreas C30-31 Nose, Sinuses etc C32 Larynx C33-34 Lung etc C37-38 Other Thoracic Organs C40-41 Bone C43 Melanoma of Skin C44 Other Skin C45 Mesothelioma C46 Kaposi Sarcoma C47+C49 Conn. & Soft Tissue C50 Breast C51 Vulva C52 Vagina C53 Cervix Uteri C54 Corpus Uteri C55 Uterus Unspecified C56 Ovary etc C57 Other Female Genital C58 Placenta C64 Kidney etc C65 Renal Pelvis C66 Ureter C67 Bladder C68 Uns.Urinary Organs C69 Eye C70-72 Brain, Nervous System C73 Thyroid C74 Adrenal Gland C81 Hodgkins Disease C82-85,C96 NHL C88 Malig Imn.Prol D C90 Multiple Myeloma C91 Lymphoid Leuk C92-94 Myeloid Leukaemia C95 Leukaemia Uns O&U Other and Uns All Sites * O&U includes the Sites ( : C26, C39, C48, C75, C76, C77, C78, C79, C80, C97) 250

16 Table: TVM-6(a): Number (#) and Proportion (%) of cancers by site () and Type of Treatment Group: Males Treatment Only at RI Type of Treatment Surgery R-Therapy C-Therapy S + R S + C R + C S + R + C Others Unknown Total # % # % # % # % # % # % # % # % # % # % C00 Lip C01-02 Tongue C03-06 Mouth C07-08 Salivary Gland C09 Tonsil C10 Oth. Oropharynx C11 Nasopharynx C12-13 Hypopharynx C14 Pharynx Unspecified C15 Oesophagus C16 Stomach C17 Small Intestine C18 Colon C19-20 Rectum C21 Anus & Anal Canal C22 Liver C23-24 Gallbladder etc C25 Pancreas C30-31 Nose, Sinuses etc C32 Larynx C33-34 Lung etc C37-38 Other Thoracic Organs C40-41 Bone C43 Melanoma of Skin C44 Other Skin C45 Mesothelioma C46 Kaposi Sarcoma C47+C49 Conn. & Soft Tissue C50 Breast C60 Penis C61 Prostate C62 Testis C63 Other Male Genital C64 Kidney etc C65 Renal Pelvis C66 Ureter C67 Bladder C68 Uns. Urinary Organs C69 Eye C70-72 Brain, Nervous System C73 Thyroid C74 Adrenal Gland C81 Hodgkins Disease C82-85,C96 NHL C88 Malig Imn. Prol D C90 Multiple Myeloma C91 Lymphoid Leuk C92-94 Myeloid Leukaemia C95 Leukaemia Uns O&U Other and Uns All Sites *O&U includes the Sites ( : C26, C39, C48, C75, C76, C77, C78, C79, C80, C97) 251 S=Surgery, R=Radiotherapy, C=Chemotherapy